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As a group, patients with epilepsy have reduced neuropsychological functioning and health-related quality of life (HRQOL), but the status of these factors is uncertain in seizure-free patients with seizure onset in adulthood on monotherapy. Nevertheless, some of these patients report neuropsychological problems. We hypothesized that subtle impairments in neuropsychological functioning and HRQOL may be underdiagnosed and related to these problems. Sixteen patients with localization-related epilepsy on monotherapy carbamazepine were compared with 16 age-, gender-, and education-matched healthy controls by means of a standardized neuropsychological screening battery, questionnaires about HRQOL (Short-Form Health Survey, SF-36), self-perceived neuropsychological functioning (Cognitive Failure Questionnaire), and mood (Profile of Mood States). No objective impairments in selective attention, memory, and executive functioning were found. However, a lower speed of information processing affecting everyday life functioning was found. Lower levels of self-perceived neuropsychological functioning were reported, whereas HRQOL was unimpaired relative to healthy controls. Physicians should not be reassured when patients receive adequate medication that prevents seizures; careful follow-up of speed of information processing and self-perceived neuropsychological functioning is needed.
Previous investigations using the partial report technique for examining adult age differences in iconic memory have suggested that older adults are less able to extract information stored in the icon than are young adults. The present study examined the hypothesis that poorer partial report performance on the part of older adults involves age-related differences in the speed of visual and auditory information processing. Elderly (M = 67 years) and young (M = 23.5 years) adults were contrasted on partial report, whole report, backward masking, and choice reaction time tasks. Results indicated that the older age group exhibited a smaller partial report advantage than did their younger counterparts. This age difference was found to be related in part to increases with age in the time required to encode and identify visual stimuli but was not related to the time required to translate auditory cues into recall instructions. In other words, the slowdown in visual information processing speed that accompanies increased age contributes to age differences in performance on tasks involving iconic memory.
We evaluated the course of neurocognitive functioning in newly diagnosed high-grade glioma patients and specifically the effect of tumor recurrence. Following baseline assessment (after surgery and before radiotherapy), neurocognitive functioning was evaluated at 8 and 16 months. Neurocognitive summary measures were calculated to detect possible deficits in the domains of (1) information processing, (2) psychomotor function, (3) attention, (4) verbal memory, (5) working memory, and (6) executive functioning. Repeated-measures analyses of covariance were used to evaluate changes over time. Thirty-six patients were tested at baseline only. Follow-up data were obtained for 32 patients: 14 had a follow-up at 8 months, and 18 had an additional follow-up at 16 months. Between baseline and eight months, patients deteriorated in information-processing capacity, psychomotor speed, and attentional functioning. Further deterioration was observed between 8 and 16 months. Of 32 patients, 15 suffered from tumor recurrence before the eight-month follow-up. Compared with recurrence-free patients, not only did patients with recurrence have lower information-processing capacity, psychomotor speed, and executive functioning, but they also exhibited a more pronounced deterioration between baseline and eight-month follow-up. This difference could be attributed to the use of antiepileptic drugs in the patient group with recurrence. This study showed a marked decline in neurocognitive functioning in HGG patients in the course of their disease. Patients with tumor progression performed worse on neurocognitive tests than did patients without progression, which could be attributed to the use of antiepileptic drugs. The possibility of deleterious effects is important to consider when prescribing antiepileptic drug treatment.
BACKGROUND: Many allergy patients complain of slowed thinking, memory problems, and difficulty sustaining attention during their allergy seasons. OBJECTIVE: This study evaluated the effect of symptomatic allergic rhinitis on speed of cognitive processing, ability to divide and sustain attention, working memory, and recent verbal memory. METHODS: Symptomatic ragweed-allergic rhinitis patients and nonatopic control subjects did cognitive testing in, out of, and in ragweed seasons. RESULTS: Test results indicate that, during ragweed seasons, allergic patients experience subtle slowed speed of cognitive processing but not deficits in attention and recent memory. Some patients also have difficulties in working memory. CONCLUSIONS: These findings suggest that having allergic reactions to ragweed pollen causes significant cognitive difficulties in a subgroup of patients.
The purpose of the current study was to examine neuropsychological functioning in a group of never-medicated first-break adolescents with psychosis. It is the first report of cognition in a sample of adolescents with psychosis in which all patients were drug-naive. Twenty-nine adolescent patients (mean age = 16.07; SD = 2.00; 15 male and 14 female patients) experiencing their first psychotic episode and 17 age-matched and sex-matched normal volunteers (mean age = 16.88; SD = 2.39; 9 male and 8 female subjects) were recruited and assessed with a neuropsychological battery. Measures of attention, memory, language, executive functioning, perceptual motor processing, and motor speed were obtained. Psychiatric symptomatology, estimated verbal IQ, and parental socioeconomic status were also determined. Patients with psychosis were significantly more impaired than normal volunteers; effect sizes were greatest in the areas of executive functioning, attention, and memory, and significantly smaller in areas of language, perceptual motor processing, and motor speed. The pattern was not altered when differences in verbal IQ and parental socioeconomic status were controlled. Sex and age interactions indicated that younger male patients were particularly impaired. The findings demonstrate neuropsychological deficits in adolescents with psychosis and suggest that cognitive deficits are core symptoms in psychotic disorders.
OBJECTIVE: To assess the relationship between asymptomatic carotid stenosis, neuropsychological test performance, and silent MRI lesions. METHODS: Performance on several neuropsychological tests was compared in 189 subjects with ultrasound-assessed carotid stenosis and 201 control subjects without carotid stenosis, recruited from a population health study. Subjects with a previous history of stroke were excluded. The test battery included tests of attention, psychomotor speed, memory, language, speed of information processing, motor functioning, intelligence, and depression. Sagittal T1-weighted and axial and coronal T2-weighted spin echo MRI was performed, and presence of MRI lesions (white matter hyperintensities, lacunar and cortical infarcts) was recorded. RESULTS: Subjects with carotid stenosis had significantly lower levels of performance in tests of attention, psychomotor speed, memory, and motor functioning, independent of MRI lesions. There were no significant differences in tests of speed of information processing, word association, or depression. Cortical infarcts and white matter hyperintensities were equally distributed among persons with and without carotid stenosis. Lacunar infarcts were more frequent in the stenosis group (p = 0.03). CONCLUSIONS: Carotid stenosis was associated with poorer neuropsychological performance. This could not be explained by a higher proportion of silent MRI lesions in persons with asymptomatic carotid stenosis, making it less likely that the cognitive impairment was caused by silent emboli.
The aim of this study was to examine possible neuropsychological changes in patients with advanced idiopathic Parkinson's disease treated with bilateral deep brain stimulation (DBS) of the subthalamic nucleus (STN). Eleven patients (age = 67 +/- 8 years, years with Parkinson's disease = 15 +/- 3, verbal IQ = 114 +/- 12) were evaluated (in their best 'on state') with tests assessing processes reliant on the functional integrity of frontal striatal circuitry, prior to the procedure (n = 11), at 3-6 months (n = 11) and at 9-12 months (n =10) post-operatively. Six of these patients were older than 69 years. Despite clinical motor benefits at 3-6 months post-operative, significant declines were noted in working memory, speed of mental processing, bimanual motor speed and co-ordination, set switching, phonemic fluency, long-term consolidation of verbal material and the encoding of visuospatial material. Declines were more consistently observed in patients who were older than 69 years, leading to a mental state comparable with progressive supranuclear palsy. 'Frontal' behavioural dyscontrol without the benefit of insight was also reported by half (three of six) of the caregivers of the elderly subgroup. At 9-12 months postoperative, only learning based on multiple trials had recovered. Tasks reliant on the integrity of frontal striatal circuitry either did not recover or gradually worsened over time. Bilateral STN DBS can have a negative impact on various aspects of frontal executive functioning, especially in patients older than 69 years. Future studies will evaluate a larger group of patients and examine the possible reversibility of these effects by turning the DBS off.
Patients with Parkinson's disease (n = 81) are compared with normal controls and three clinical groups, each representing a different level of cerebral impairment (TIA; Stroke; Alzheimer's disease (AD) and multi-infarct dementia (MID). Psychometric measures of abstract reasoning, speed of information processing, verbal and visual memory, visuospatial perception and psychomotor functions are taken using a neuropsychological test battery with appropriate age-correction and normalized scaling. Following differentiation between the uncomplicated idiopathic Parkinson's syndrome and Parkinson plus (signs of cerebral polypathy and/or a degenerative process exceeding the nigro-striatal system) the neuropsychological profile reveals intellectual impairments approaching the dementia level (AD/MID) only in the Parkinson plus subgroup. With the exception of the severe motor deficiencies, the overall performance of patients with an uncomplicated Parkinson's syndrome is largely on the level of age-matched controls. Slight deficits exist only in the speed of information processing (action under time restriction) and in visuoconstructive performance.
On measures of speeded performance, persons with mental retardation typically respond more slowly than do those without mental retardation. A review of 45 published studies yielded 518 pairs of response times (RTs) in which each pair consisted of a mean RT for a group of persons with mental retardation for an experimental condition and the corresponding mean RT for a group of persons without mental retardation. The primary result was that RTs of individuals with mental retardation increased linearly as a function of RTs for persons without mental retardation in corresponding conditions. These results are consistent with the view that differences in processing speed between persons with and without mental retardation reflect some general (i.e., nontask specific) component of cognitive processing. Possible candidates for the general component were discussed.
This paper shows that cortical processing of information quantity can be given in bits, while speed of information processing can be given in bit/sec; therefore the information processing ability can be denoted in algebraical expression. Changes of emotional tension can be objectified by galvanic skin reflex and pulse reaction. This method and device is suitable to measure psychic state of space station personnel and to predict psychic activity.
Electrocortical and behavioral responses of low, moderate, and high physically active older adults were compared with a younger control group on neutral and incompatible conditions of a flankers task. Compared to younger adults, high and moderate active older adults exhibited increased event-related potentials component P3 amplitude for the incompatible condition at the frontal electrode site. For the neutral condition, only low active older adults exhibited decreased amplitude at the central-parietal site, compared to younger adults. P3 latency revealed the longest latencies for low active older adults, followed by moderate active, high active, and younger adults, respectively. Reaction time (RT) data revealed that younger adults exhibited faster RT compared to all three older groups. Results suggest that physical activity may improve executive control function in older adults by affecting the distribution of P3 amplitude, which has been related to memory and attentional processes, and by decreasing P3 latency, which relates to the speed of cognitive processing.
The inhibitory effect of lipophilic acids, antimicrobial food additives, and analgesics-antipyretics was examined at concentrations from 0.1 to 100 mM in bacteria (Bacillus subtilis and Escherichia coli) and mammalian cells (HeLa, human fibroblasts, and mouse neuroblastoma cells). Most compounds inhibit the growth of HeLa cells about as efficiently as that of B. subtilis. However, butyrate and propionate, as well as acetaminophen, antipyrene, phenacetin, and salicylamide, inhibit HeLa at millimolar concentrations whereas, at least 10 times higher concentrations are needed to inhibit B. subtilis. The concentrations needed to inhibit growth by 50% decrease with increasing octanol-water partition coefficients of the compound. Growth of E. coli is inhibited similar to that of B. subtilis by all compounds except butylbenzoate, decanoate, and linoleate which cannot penetrate the lipopolysaccharide layer. All growth inhibitors inhibit amino acid uptake into bacteria and their vesicles, and oxygen consumption in bacteria. In HeLa cells or human fibroblasts, neither amino acid uptake nor adenine 5'-triphosphate synthesis are inhibited by fatty acids at concentrations that completely inhibit growth. Short chain fatty acids (propionate, butyrate, and pentanoate) induce in HeLa the formation of cell processes. In neuroblastoma cells, grown in the presence of 10% fetal calf serum, butyrate also induces such processes which slowly continue to grow in length for at least 7 days; these processes differ in speed of formation, width, and cycloheximide susceptibility from the thin processes produced by serum deprivation alone.
OBJECTIVE: The objective of this study was to introduce continuous glucose-error grid analysis (CG-EGA) as a method of evaluating the accuracy of continuous glucose-monitoring sensors in terms of both accurate blood glucose (BG) values and accurate direction and rate of BG fluctuations and to illustrate the application of CG-EGA with data from the TheraSense Freestyle Navigator. RESEARCH DESIGN AND METHODS: We approach the design of CG-EGA from the understanding that continuous glucose sensors (CGSs) allow the observation of BG fluctuations as a process in time. We account for specifics of process characterization (location, speed, and direction) and for biological limitations of the observed processes (time lags associated with interstitial sensors). CG-EGA includes two interacting components: 1) point-error grid analysis (P-EGA) evaluates the sensor's accuracy in terms of correct presentation of BG values and 2) rate-error grid analysis (R-EGA) assesses the sensor's ability to capture the direction and rate of BG fluctuations. RESULTS: CG-EGA revealed that the accuracy of the Navigator, measured as a percentage of accurate readings plus benign errors, was significantly different at hypoglycemia (73.5%), euglycemia (99%), and hyperglycemia (95.4%). Failure to detect hypoglycemia was the most common error. The point accuracy of the Navigator was relatively stable over a wide range of BG rates of change, and its rate accuracy decreased significantly at high BG levels. CONCLUSIONS: Traditional self-monitoring of BG device evaluation methods fail to capture the important temporal characteristics of the continuous glucose-monitoring process. CG-EGA addresses this problem, thus providing a comprehensive assessment of sensor accuracy that appears to be a useful adjunct to other CGS performance measures.
Risperidone appears to have a beneficial effect in several areas of cognitive function in schizophrenic patients. In previous studies, however, the clinical characteristics of the subjects differed between studies, and were heterogeneous even in single study. Most of the subjects were previously exposed to different kinds of neuroleptics and some of them were treatment-resistant. The aim of this study is to evaluate the effect of risperidone on attention and information processing in a homogeneous subgroup of schizophrenic patients, i.e. drug-naïve first-episode inpatients. In the patient group (n=17), cognitive tests and clinical assessments were performed before and after 8 weeks of risperidone treatment. The same cognitive tests were administered to the control group (n=24). The delay between test and retest was 8 weeks. Before treatment, the patient group performed significantly worse than control group on the tests measuring continuous attention, vigilance, and the speed of information processing. After treatment (the average dose of risperidone was 7.3mg/day), in spite of significant improvement of the clinical symptoms, the patients did not show any significant improvement or worsening in most of the items of these tests. The control group did not show any practice effect. These results suggest that first-episode schizophrenic patients have deficits in sustained attention and vigilance to visual stimuli, as well as the speed of information processing to visual and auditory stimuli, and these deficits are unrelated to clinical symptoms and remain stable during the early phase of treatment. This study did not receive pharmaceutical company financial support.
The technique of single-particle electron cryomicroscopy is currently making possible the 3D structure determination of large macromolecular complexes at constantly increasing levels of resolution. Work at resolution now attainable requires many thousands of individual images to be processed computationally. The most time-consuming step of the image-processing procedure is usually the iterative alignment of individual particle images against a set of reference images derived from a preliminary 3-D structure. We have developed an improved multireference alignment procedure based on interpolated cross-correlation images (corrims) that results in an approximately 8-fold acceleration of the iterative alignment steps. These corrims can be used to restrict the number of image-alignment calculations by narrowing down the set of reference images. Another improvement in alignment speed has been achieved by optimising the software and its implementation on many parallel processors. This new corrim-based refinement has been found to work well with two different alignment algorithms, the commonly used "fast alignment by separate translational/rotational searches" and "exhaustive alignment by polar coordinates."
Fifty-one patients suffering from soft tissue injury of the cervical spine underwent clinical and psychometric examination. Clinical interview evaluated subjective complaints and formal testing of self-estimated cognitive impairment, divided attention, and speed of information processing. Results indicated at least two different syndromes: 1) the "cervicoencephalic syndrome," characterized by headache, fatigue, dizziness, poor concentration, disturbed accommodation, and impaired adaptation to light intensity; and 2) the "lower cervical spine syndrome," which is accompanied by cervical and cervicobrachial pain. When comparing patients with either of these two syndromes, those suffering from cervicoencephalic syndrome had significantly poorer results when tested for divided attention. Speed of information processing was reduced to a comparable extent in both syndromes. These findings were not related to the length of the post-traumatic interval. Reduced processing of working memory is assumed, which may account for more global cognitive problems as well as secondary neurotic reaction.
Subjects performed a signal discrimination task under four conditions: normal pace, accuracy, speed, and SATO (equal effort to speed and accuracy). Characteristically, schizophrenics demonstrated decreased accuracy, poorer compliance, increased total response time, and increased simple reaction time. Surprisingly, central processing time (decision time) was equivalent. Analysis of processing resource allocation identified significant group differences only under the SATO condition. Here, controls balanced attentional resources but patients worked almost exclusively for speed. Under conjoint performance conditions, patients apparently minimize categorical processing time at the expense of accuracy. These data are interesting as they identify specific circumstances under which schizophrenics manifest an attentional deficit.